What the ‘small lump’ on the prostate of Biden can mean for the health of a man

Former President Jooesph Biden has described what a spokesperson described as A “small lump” in his prostate. How concerned a patient should be through such a finding depends on the circumstances, urologists said.

In some cases, nodules are caused by inflammation, so that the prostate can feel firmer, or can lead to calcifications in the prostate that feel like nodules. These are benign.

They can also be the result of a common disorder in older men, nodular benign prostatic hypertrophy, in which not -threatening nodules form in the prostate, which increases it. These are also not a risk.

But in the worst case it can be cancer.

When a urologist feels a lump in a man’s prostate, it is not always clear what to make, Dr. Scott Eggener, a urologist at the University of Chicago.

“There are absolutely times when it is vague and ambiguous and you don’t know what it is,” he said, adding that a growth can feel like “a large large rock that is almost certainly cancer.”

But, Dr. said Egener, he wonders why a doctor in the first place investigated the prostate of Mr Biden manually. Perhaps he had a new symptom, such as a urine issue, or pain, or an increased level of prostate-specific antigen, or PSA, a blood protein whose level rises with prostate cancer.

If the exam was only part of routine screening, it would be contrary to guidelineS published by professional organizations that argue against prostate screening for men Mr Biden’s ageUnless they are in unusually good health.

That is because prostate cancer tends to grow slowly or not at all and is very common at the age of Mr Biden, Dr. Eggener.

“At least 50 percent of men of his age have cancer in their prostate,” said Dr. Egener. “The vast majority is better not to know about it.” They can die with the slowly growing cancer, not from it. They may not have any symptoms and it cannot threaten their lives.

Screening for a man who is the age of Mr. Biden is “very controversial,” Dr. Judd Moul, a urologist at Duke University.

However, he was screened, so “I think it is water under the bridge at this point,” said Dr. Moul. “Someone has taken a digital rectal exam and found something that they considered abnormal.”

Now the problem will be how to evaluate the finding.

A usual method would be to perform a PSA test. As an alternative, he could have a new urine test that is looking for genetic signals of cancer.

Doctors were able to investigate Mr Biden’s prostate with an MRI or ultrasound.

“In the end, if they think this lump is prostate cancer, the last step would be a biopsy,” said Dr. Moul.

And then, if it is cancer, Mr Biden would be confronted with the difficult decision whether or not to have it treated, what may require surgery or irradiation.

“Sometimes when we are confronted with older gentlemen with prostate lumps and other health problems, this may be appropriate to check it,” said Dr. Moul.

Dr. Moul said that before he went on the path of further testing, he would first have a long conversation with a patient like Mr. Biden about what that could lead. If a patient finds out that he has prostate cancer, he must decide whether he should undergo the treatment, which can be difficult, or live with the knowledge that he has cancer and that he chooses not to treat it.

“I would try to make a shared decision with him before I continued testing,” said Dr. Moul.

Mr Biden’s spokesperson said he had spent Friday in a hospital in Philadelphia and underwent an additional evaluation.